DiscoRodeo
kiwifarms.net
- Joined
- Jun 10, 2020
I feel like I'm repeating myself and I tend to choose not to do that: If you don't have insurance, or have very, very poor/basic insurance coverage and expect them to pay for the moon.Yes. Depending on the procedure and the hospital you're in, it can absolutely run that high. Transplants alone will rack up over 250k.
Then this is contradictory, its the equivalence of "well, my policy should cover this" vs "no it shouldnt" vs "yes it should". Aka: The problem of people paying for ultra basic insurance (a minimum) and expecting everything to be covered under that. Did he have a bronze plan? A silver plan? A gold plan? A platinum plan? Was it HMO? Did he get HMO from a non-approved vendor/out of plan vendor? Was it PPO with higher premiums?As I mentioned before, even Dr. Mike had to call to bitch to an insurance company to get a procedure covered the patient required. It happens quite often, both from anecdote and data.
You can go on, easily- with different insurance plans.
The fact that hospitals inflate prices is a sad thing, but its a separate issue to being on something like a bronze plan where you wind up having to foot the bill for half the cost, when being on a platinum plan will eliminate 90% of the cost of any illness upfront. Thats not even starting with the fact that insurance companies adjust premiums based off of income levels, and theres additional government support programs and waivers as well.Transplants alone will rack up over 250k.
For example:
I get that medical debt is a big issue in the US, its why I said earlier that the way the system is, it fucks over people working minimum wage jobs as adults.the max out of pocket for out of network Medicare is still under $10K.
But its just not the case that everyone is overburdened with medical debt for no reason. You make choices, its a free market (arguably). You have the choice to get on an insurance plan when youre younger. You have the choice to choose the plan with the lowest possible premiums and the least coverage, or something in-between- or something with maximum coverage, you choose. You have the choice to exercise, to stay healthy, to add to lowering those monthly premiums if you so wish it.
90% of the time, a claim is denied because someone decided to go to a non-approved vendor for medical treatment. I can tell you from legal, at one point in the 2010s, you'd see dozens of cases a week of people trying to cheat the system by going to a private doctor to prescribe "pain medication" for treatment, aka medical marijuana, and then trying to sue the company to claim that "my plan covers pain relief, why won't you do this". Consider that an extreme case (though it was painstakingly common enough for a period), but you can get the idea of when and how claims get denied- and how claims successfully go through. Documented condition, client goes to approved vendor for appraisal. Client goes to approved vendor for treatment. Client follows rehabilitation plan. Client doesn't try to run a side business selling online tickets while taking long term sickness benefits for the "inability" to work, etc.As I mentioned before, even Dr. Mike had to call to bitch to an insurance company to get a procedure covered the patient required. It happens quite often, both from anecdote and data.
Like insurance or not, there are internal rules the companies follow, and the way people view it is honestly so simplistic and doesn't really give you a good idea of how it operates- let alone leaves others financially illiterate towards the system. If there's one thing people should be literate on, its insurance policies.
For me, I don't think its a perfect system- but it has two things that the Canadian system doesn't have that I think are crucifying us right now. Choice, and responsibility.
I don't have a choice of who I go to in Canada. I have to wait in line for up to a year to get actual life and death surgeries, if I need them. Right now, most of us would probably love to have the option for loved ones ailing to get them treatment, right now. I've got an aunt with a large tumor thats knocking her eye out of its socket right now, who has been on a waiting list since last year for treatment.
This system has no sense of responsibility. Whatever your health condition is, you get treatment. However long youre a citizen or a resident, you get treatment. Its part of why people flock to Canada to bring their entire families over, overburdening the system. Regardless of financial contribution, you have the same exact care. Maybe equality is good on paper, but what about the family eating itself to death? What about the Indian national who just moved his extended family into a long term hospice over here after living here for the minimum amount of time? We've taken this system for granted for so long, that our doctors are underpaid and have a flat salary, they can't even pay off their student debt and most move to the US for better pay as a result, and the government refuses to own up to the fact that years of limiting the amount of licensed medical practitioners has effectively crippled the industry on top of that.
There's benefits that we're all getting the same treatment and your medical treatment is being paid for by our high earners taxes, but what good is that treatment when youre not even going to get it when your dying of cancer on a waiting list.
This is much more broken than US healthcare.
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